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House Okays Doc Fix, Bill Sent to White House for Signature

Janice Simmons, for HealthLeaders Media, June 25, 2010

After several days of waiting and seeing what would happen with the Senate's jobs bill, the House decided in a lopsided 417-1 vote on Thursday evening to approve the measure (HR 3962) that would postpone (until Nov. 30) a 21% cut in Medicare and TRICARE reimbursements to physicians. The approved bill was then sent to the White House for President Obama's signature.

The Senate had approved the $6.4 billion bill last Friday, but House Speaker Nancy Pelosi (D-CA) held back any vote earlier in the week in anticipation of the Senate approving the long-delayed jobs bill (HR 4213). The Senate doc fix amendment was carved out the jobs bill last week and scheduled for the separate vote by Finance Committee Chairman Max Baucus (D-MT) and Ranking Minority Member Charles Grassley (R-IA).

Hours before the Thursday House vote, Pelosi indicated at her weekly press conference she wanted to see a more complete bill from the Senate—which included extensions to COBRA unemployment benefits through the end of November and funding through June 2011 for the Federal Medical Assistance Percentages (FMAP) funding—before voting just on the doc fix.

The House had passed its jobs bill prior to the Memorial Day weekend. However, it appeared this week that the votes were not there yet in the Senate. "I'm hard pressed to pass any more initiatives here unless there's some reasonable prospect of success on the Senate side," Pelosi said.

The Centers for Medicare and Medicaid Services (CMS) began implementing the 21% cut last Friday in processing claims. However, the new bill restores the cuts back to June 1 and provides an additional 2.2% raise for physician reimbursements through Nov. 30.

After the bill was approved by the House, President Obama said in a statement that he was "pleased that Congress has acted to ensure the security of our seniors’ health care. A 21% pay cut to physicians’ payments would have forced some doctors to step seeing Medicare patients—an outcome we can all agree is unacceptable."

He also restated that a permanent fix to the Medicare formula was needed that "attacks our fiscal problems without punishing our hard working doctors or endangering the benefits on which so many of our seniors rely."

New American Medical Association President Cecil Wilson, MD, said in a statement that seniors already are experiencing access problems "as a result of the complete congressional mismanagement of Medicare over the years."

"About one in four Medicare patients looking for a new primary care physician are having trouble finding one. About one in five physicians are already limiting the number of Medicare patients they treat because of the instability and uncertainty of Medicare payment," Wilson said.

Wilson said that in December, the Medicare physician payment cut will be 23%—increasing to nearly 30% in January. "Congress is playing a dangerous game of Russian roulette with seniors’ healthcare," Wilson said. "Sick patients can’t wait. Congress must replace the broken payment system before the damage is done and cannot be reversed."

William Jessee, MD, president and CEO of the Medical Group Management Association, said that the "short term relief provided by passage" of the bill to avert the 21% Medicare payment cut to physicians "belies the fact that Congress continues to act irresponsibly in addressing the flawed sustainable growth rate formula."

He added that extending the latest payment to November will be disruptive to many medical groups. In particular, the current doc fix period expires in November—just one month before the start of the next fiscal year for most medical groups.

"It throws responsible business planning for 2011 into complete disarray and occurs exactly when physicians will make the difficult decision to participate in Medicare for the coming year," Jessee said.

In a statement, bill authors Baucus and Grassley said: "Our House colleagues deserve praise for standing with us today to help fulfill our responsibility to seniors and military families."


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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